Diabetic foot ulcers (DFUs) are a critical complication of diabetes associated with a high risk of amputation and mortality. Despite the availability of numerous classification systems, the clinical outcomes remain suboptimal because of the complex pathophysiology of DFU and the lack of a universally applicable approach across different healthcare settings. This review compares the major DFU classification systems and proposes a practical framework to support clinical decision-making according to the disease stage and institutional capacity. A comparative analysis was performed on major DFU classification systems, including the Wagner; University of Texas (UT);Perfusion, Extent/size, Depth/tissue loss, Infection, and Sensation (PEDIS) classification; Site, Ischemia, Neuropathy, Bacterial Infection, Area, and Depth (SINBAD) classification; and the Society for Vascular Surgery (SVS) Wound, Ischemia, and foot Infection (WIfI) systems. Their strengths and limitations were evaluated based on their clinical applicability, prognostic value, and usefulness in different healthcare environments. Although the Wagner and UT systems offer clinical convenience for initial assessment and monitoring, they do not provide sufficient detailed information for complex surgical planning. By contrast, the WIfI classification provides a more precise prediction of the amputation risk and revascularization benefit, even though it requires an objective vascular assessment that may not be readily available in primary care settings. This study introduces a “Scenario-based Stepwise Escalation Framework” to resolve “classification fatigue.” This model uses SINBAD/Wagner for initial screening, UT/PEDIS for specialized management, and WIfI for advanced surgical interventions and revascularization. The optimal classification strategy for DFU should be selected flexibly based on the clinical stage of the disease and the diagnostic capabilities of the treating institution. Rather than recommending a single universal classification system, this review supports the complementary use of multiple systems according to specific clinical needs. A stage- and setting-based approach may facilitate multidisciplinary communication and assist clinical decision-making in DFU management. Future prospective studies will be needed to validate the clinical effectiveness of the proposed framework.

Purpose: This study was aimed to identify the effect of Mulligan knee taping (MKT) application on the hip joint muscle activity and lower extremity kinematic during single leg squat. Methods: Twenty healthy male partisipants, aged between 19 and 29 years, were measured for hip joint muscle activity, medial knee displacement, and hip adduction angles according to the application of MKT. In single leg squat, the eccentric, isometric, and concentric contraction phases were performed until the knee flexed at a depth of 60°. The muscle activity (unit, %MVIC) of hip joints in each phase and the medial knee displacement (unit, cm) and hip adduction angle (unit, °) were analyzed before and after the application of MKT during single leg squat. All measurements were performed with the dominant leg, and the order of MKT and non-taping was randomly determined by drawing lots. Results: During single leg squat, the muscle activity of the gluteus maximus muscle in the eccentric and isometric contraction phases significantly increased when MKT was applied than when non-taping (p=0.048 and p=0.012, respectively). There was no statistically significant difference between the muscle activity of other lower extremity muscles and the medial knee displacement and hip adduction angle (p＞ 0.05). Conclusion It was confirmed that the activity of the gluteus maximus muscle increased in the case where single leg squat was performed after applying MKT, compared to the case where it was performed without application. Therefore, MKT application is recommended to increase the muscle activity of the gluteus maximus during single leg squat.

BACKGROUND: This study aimed to identify the characteristics of claimed mental disorders. Because the workers believed the cause of the mental disorders was work-related stress or a specific event, we could identify the major work-related stressor for claimed cases. METHODS: We included claimed cases of occupational mental disorder or suicide reported during 2010–2014 to the Korea Workers Compensation and Welfare Service (KCOMWEL), established by Industrial Accidents Insurance (IACI) Act. We conducted qualitative analysis using a form specifically developed for this study as well as a quantitative analysis. RESULTS: Of the 569 claimed cases, 142 cases were recognized as occupational mental disorder or suicide. The approval rate was 24.9 %. Suicide was the most commonly approved mental disorder (23.0 %), followed by major depressive disorder (14.9 %). Regarding profession, 109 workers were managers, and 95 workers were office clerks. The main work-related stressors of the approved cases were acute stressful events (76 cases), long working hours (12 cases), and changes in workload (6 cases). The primary stressful events were work-related legal problems, workplace violence, and employment status-related issues. CONCLUSION: Claims due to mental disorders or suicide increased during the 5-year study period, and the approval rate was approximately 33 %, and the main stressor of the claimed cases was an acute stressful event such as physiologic trauma, employment-related issues, fear of legal or financial responsibility, abrupt change in organizational responsibility, or workplace violence.
Accidents, Occupational ; Depressive Disorder, Major ; Employment ; Insurance ; Korea ; Life Change Events ; Mental Disorders* ; Suicide* ; Workers' Compensation ; Workplace Violence

alpha-Asarone exhibits a number of pharmacological actions including neuroprotective, anti-oxidative, anticonvulsive, and cognitive enhancing action. The present study investigated the effects of alpha-asarone on pro-inflammatory cytokines mRNA, microglial activation, and neuronal damage in the hippocampus and on learning and memory deficits in systemic lipopolysaccharide (LPS)-treated C57BL/6 mice. Varying doses of alpha-asarone was orally administered (7.5, 15, or 30 mg/kg) once a day for 3 days before the LPS (3 mg/kg) injection. alpha-Asarone significantly reduced TNF-alpha and IL-1beta mRNA at 4 and 24 hours after the LPS injection at dose of 30 mg/kg. At 24 hours after the LPS injection, the loss of CA1 neurons, the increase of TUNEL-labeled cells, and the up-regulation of BACE1 expression in the hippocampus were attenuated by 30 mg/kg of alpha-asarone treatment. alpha-Asarone significantly reduced Iba1 protein expression in the hippocampal tissue at a dose of 30 mg/kg. alpha-Asarone did not reduce the number of Iba1-expressing microglia on immunohistochemistry but the average cell size and percentage areas of Iba1-expressing microglia in the hippocampus were significantly decreased by 30 mg/kg of alpha-asarone treatment. In the Morris water maze test, alpha-asarone significantly prolonged the swimming time spent in the target and peri-target zones. alpha-Asarone also significantly increased the number of target heading and memory score in the Morris water maze. The results suggest that inhibition of pro-inflammatory cytokines and microglial activation in the hippocampus by alpha-asarone may be one of the mechanisms for the alpha-asarone-mediated ameliorating effect on memory deficits.
Animals ; Cell Size ; Cytokines* ; Head ; Hippocampus ; Immunohistochemistry ; Learning ; Maze Learning ; Memory ; Memory Disorders* ; Mice* ; Microglia ; Neurons ; RNA, Messenger ; Swimming ; Tumor Necrosis Factor-alpha ; Up-Regulation

alpha-Asarone exhibits a number of pharmacological actions including neuroprotective, anti-oxidative, anticonvulsive, and cognitive enhancing action. The present study investigated the effects of alpha-asarone on pro-inflammatory cytokines mRNA, microglial activation, and neuronal damage in the hippocampus and on learning and memory deficits in systemic lipopolysaccharide (LPS)-treated C57BL/6 mice. Varying doses of alpha-asarone was orally administered (7.5, 15, or 30 mg/kg) once a day for 3 days before the LPS (3 mg/kg) injection. alpha-Asarone significantly reduced TNF-alpha and IL-1beta mRNA at 4 and 24 hours after the LPS injection at dose of 30 mg/kg. At 24 hours after the LPS injection, the loss of CA1 neurons, the increase of TUNEL-labeled cells, and the up-regulation of BACE1 expression in the hippocampus were attenuated by 30 mg/kg of alpha-asarone treatment. alpha-Asarone significantly reduced Iba1 protein expression in the hippocampal tissue at a dose of 30 mg/kg. alpha-Asarone did not reduce the number of Iba1-expressing microglia on immunohistochemistry but the average cell size and percentage areas of Iba1-expressing microglia in the hippocampus were significantly decreased by 30 mg/kg of alpha-asarone treatment. In the Morris water maze test, alpha-asarone significantly prolonged the swimming time spent in the target and peri-target zones. alpha-Asarone also significantly increased the number of target heading and memory score in the Morris water maze. The results suggest that inhibition of pro-inflammatory cytokines and microglial activation in the hippocampus by alpha-asarone may be one of the mechanisms for the alpha-asarone-mediated ameliorating effect on memory deficits.
Animals ; Cell Size ; Cytokines* ; Head ; Hippocampus ; Immunohistochemistry ; Learning ; Maze Learning ; Memory ; Memory Disorders* ; Mice* ; Microglia ; Neurons ; RNA, Messenger ; Swimming ; Tumor Necrosis Factor-alpha ; Up-Regulation